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Study > Burn Complications > Flashcards

Burn Complications Flashcards

1
Q

A client has circumferential burns. What does this mean?

A

Burn around like a circle; check circulation!

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2
Q

What is a circulatory check?

A

Pulse
Cap refill
Skin temp
Skin color

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3
Q

What is turgor?

A

Hydration check

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4
Q

What check is sensation?

A

Neurovascular

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5
Q

What if the vascular check in the arm is bad, how do you relieve pressure?

A

Escharotomy

Fasciotomy

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6
Q

What pressure relief?

Relieves the pressure and restores the circulation, cuts through eschar

A

Escharotomy

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7
Q

What pressure relief?

Relieves the pressure and restores circulation but cut is much deeper into tissue; cuts through fascia of muscle

A

Fasciotomy

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8
Q

Renal system

An indwelling catheter is inserted to measure UO. How often?

A

Hourly

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9
Q

Renal system

T/F: May put in catheter and no UO

A

T

Kidneys may be trying to hold with little fluid is there or they aren’t being perfused adequately

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10
Q

Renal system

What do you do if UO is brown or red?

A

Call doc

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11
Q

Renal system

What drug may be given to flush out kidneys?

A

Mannitol

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12
Q

Renal system

T/F: No diuretics given to burn patients

A

T and F; may give mannitol only to flush out kidneys

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13
Q

Renal system

What about Mannitol to know

A

It crystalizes

Do not refridgerate; don’t give if it has crystals

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14
Q

Renal system

If there is no UO or if it is less than 30mL/hr, what to worry about

A

Kidney failure

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15
Q

Renal system

After 48 hours, what does client begin to do?

A

Diurese because fluid is going back to vascular space and now we worry about fluid volume excess

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16
Q

Electrolyte imbalance

What happens here?

A

Burns cause cells to break. Cells have K. If cells break, K leaks and that causes HYPERkalemia

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17
Q

Electrolyte imbalance

S/s of hyperkalemia?

A

Muscle twitching
Muscle weakness
Flaccid paralysis
Cardiac dysrhythmias

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18
Q

GI system

What may be ordered to prevent stress ulcer?

A

Magnesium carbonate
Pantoprazole
Famotidine

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19
Q

GI system

What ulcer is common with burns?

A

Stress ulcer (Curlings)

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20
Q

GI system

Why would doc want client to be NPO and have NG hooked to suction?

A

Could develop paralytic ileum because decrease vas. volume, decreased GI motility, and HYPERkalemia

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21
Q

GI system

How to help with GI motility to prevent paralytic ileum?

A

Rocking chair

22
Q

GI system

What happens if client doesnt have bowel sounds

A

Abdominal girth increases

23
Q

GI system

Burns patients need more what?

A

Calories
Vit C
Protein

24
Q

GI system

When is NG tube removed?

A

When you hear bowel sounds

25
Q

GI system

When you start GI feedings, what should be measured?

A

Residuals

26
Q

GI system

When to hold next feed?

A

If residual is more than 50 mL

*still give back the residual so you don’t cause any imbalances, just don’t give next feed

27
Q

GI system

How to check proper nutrition and positive nitrogen balance?

A

Pre-albumin levels

28
Q

Integumentary-Contractures

Damage only to epidermis

A

Superficial thickness

29
Q

Integumentary-Contractures

Damage to entier epidermis and varying depth of dermis

A

Partial thickness

30
Q

Integumentary-Contractures

Damage to entire dermis and sometimes fat

A

Full-thickness

31
Q

Integumentary-Contractures

If they have burns on hands, what are good ways to prevent contractors?

A

Wrap each finger separately

Use splints

32
Q

Integumentary-Contractures

What if neck burns?

A

Hyperextend neck

No pillows–to promote chin-to-chest contracture

33
Q

Integumentary-Infections

What is #1 complication with perineal burn?

A

Infection

34
Q

Integumentary-Infections

What is eschar?

A

Dead tissue

*if not removed, new tissue doesnt regenerate

35
Q

Integumentary-Infections

What likes to grow in eschar?

A

Bacteria

36
Q

Integumentary-Tretament

What type of isolation?

A

Protective

37
Q

Integumentary-Tretament

What agents to remove necrotic, dead tissue?

A

Sutilains or collagenase

*both enzymatic drugs

38
Q

Integumentary-Tretament

Rules for the enzymatic drugs?

A

Don’t use on face
Don’t use if pregnant
Don’t use over large nerves
Don’t use if area is opened to body cavity

39
Q

Integumentary-Tretament

What is also used to debrid?

A

Hydrotherapy

  • give pain med before
  • worry about cross contamination with immersion hydrotherapy
40
Q

Integumentary-Tretament

Mafenide acetate

A

Can cause acid base problems
Stings
If rubs off, apply more

41
Q

Integumentary-Tretament

Silver nitrate

A

Keep dressing wet

Can cause electrolyte problems

42
Q

Integumentary-Tretament

Providone-iodine

A

Stings and stains
Can cause allergies
Can cause acid-base problems

43
Q

Integumentary-Tretament

Why to alternate antibiotic drugs?

A

Bacteria can build resistance or tolerance

44
Q

Integumentary-Tretament

Broad spectrum antibiotics are avoided why?

A

To prevent superinfection or secondary infections

*broad spectrum antibiotics may be used until wound cultures have returned–always get culture before starting antibiotic

45
Q

Integumentary-Tretament

Mycin drugs

A

Worry about BUN or Cr increasing (neprotoxicity)

Worry about hearing (ototoxicity)

46
Q

Integumentary-Grafting

How much to remove of burn tissue?

A

Till you see healthy tissue

47
Q

Integumentary-Grafting

What is an autograft?

A

Autograft uses own skin

Good skin taken from healthy donor site and placed over burned area –donor site= open wound and dressing applied till bleeding stops –then donor site is left open to air

48
Q

Integumentary-Grafting

If client is well nourished, how often can the surgeon reharvest from same donor site?

A

Every 12-14 days

49
Q

Integumentary-Grafting

If skin graft becomes blue or cool, what does this mean?

A

Poor circulation

50
Q

Integumentary-Grafting

Why would doc want you to roll sterile Q-tips over graft with steady gentle pressure from center of graft out to edges?

A

To get fluid out between graft and tissue to keep graft site intact (aka keep graft to adhere)

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